中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (6): 716-720.doi: 10.13418/j.issn.1001-165x.2021.06.017

• 临床研究 • 上一篇    下一篇

比较踝关节骨折后踝螺钉不同进钉方向固定疗效

胡秀年1,    刘辉2,    占鹏1,    陈日江1,    廖元军1,    兰伟斌1,    邱汉民1,    陈东风1   

  1. 福建医科大学附属龙岩第一医院     1.骨科,  2.检验科,  福建   龙岩    364000
  • 收稿日期:2020-03-17 出版日期:2021-11-25 发布日期:2021-12-01
  • 作者简介:胡秀年(1985-),男,福建省永定人,硕士,主治医师,研究方向:骨科基础与临床,E-mail:huxiunian@163.com
  • 基金资助:
    福建省自然科学基金项目(2018J01404);福建省卫生健康委青年科研课题(2017-1-96);龙岩市科研项目(2017LY86)

Comparison of the effect of ankle screw fixation in different directions after ankle fracture

Hu Xiunian1, Liu Hui2, Zhan Peng1, Chen Rijiang1, Liao Yuanjun1, Lan Weibin1, Qiu Hanmin1, Chen Dongfeng1   

  1. 1.Department of Orthopedics, Longyan First Hospital, Affiliated to Fujian Medical University, Longyan 364000, China;  2. Department of Clinical Laboratory, Longyan First Hospital, Affiliated to Fujian Medical University, Longyan 364000, China
  • Received:2020-03-17 Online:2021-11-25 Published:2021-12-01

摘要:  目的    比较踝关节骨折后侧入路后踝螺钉不同进钉方向的固定疗效。  方法    选取漂浮体位下后外侧入路对后踝骨折分别采用不同进钉方向螺钉固定患者48例,男性20例,女性28例,年龄(51.88 ± 7.90)岁,左踝20例,右踝28例,依据Lauge-Hansen踝关节骨折分型:旋后外旋型Ⅳ度36例,旋前外旋型Ⅳ度12例。后踝均采用螺钉固定,前向后固定组22例,后向前固定组26例,对比两组手术时间、骨折愈合时间及并发症情况,末次随访采用AOFAS评分进行临床疗效评价。  结果    两组病例均获随访,随访时间10~20个月,平均(13.0±3.5)个月,均Ⅰ期愈合,无切口感染、血管神经损伤等并发症,手术时间、骨折愈合时间、AOFAS评分均未见统计学差异,P>0.05。  结论    后外侧入路固定后踝骨折疗效较好,螺钉不同进钉方向具有相似的临床固定结果,手术医生可凭经验选择合适的方法。

关键词: 踝关节骨折,  ,  , 后踝骨折,  ,  , 螺钉固定

Abstract:  Objective    To compare the effect of different fixation direction of posterior lateral approach on ankle fracture.    Methods    Forty-eight patients, including 20 males and 28 females, aged (51.88 ± 7.90) years old, 20 left ankles and 28 right ankles were collected for posterior malleolus fractures fixation by posterior lateral approach in floating position, respectively. According to the classification of Lauge-Hansen fracture of ankle joint, 36 cases had supination-extorsion and 12 had pronation-abduction. All posterior malleolus were fixed with screws, including 22 cases in the forward to backward fixation group and 26 cases in the backward to forward fixation group. The time of incision healing and complications, fracture healing time, the last follow-up were evaluated by AOFAS score and operation time between two groups were compared.    Results    Patients in the two groups were followed up for 10-20 months, with an average of (13±3.5) months. All patients were healed at stage I, there was no incisional infection, blood vessel and nerve damage. There was no statistical difference in operation time, fracture healing time, AOFAS score (P>0.5). Conclusions    The posterior lateral approach for fixation of posterior malleolus fractures has a good effect. Different screw fixation directions have similar clinical results,  so surgeons can choose the appropriate method based on their experience.

Key words:  , Ankle fractures,  ,  , Posterior malleolar fractures,  ,  , Screw fixing

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